c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Neoaortoiliac System (NAIS) Bypass of Infected Aortofemoral Graft: 16

A D V E R T I S E M E N T

   
 

After systemic anticoagulation, the proximal aorta was cross-clamped, and the entire prosthetic graft was excised. The vein graft was sewn end-to-end to the infrarenal aortic stump. There was an excellent size match between these two structures.       

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Neoaortoiliac System (NAIS) Bypass of Infected Aortofemoral Graft: 17

A D V E R T I S E M E N T

   
 

The vein graft was tunneled retroperitoneally to reach the left groin incision. After the prosthetic graft was excised from the common femoral artery, the SFPV graft was sewn end-to-side to the site of the old common femoral artery anastomosis, extending across the orifice of the profunda femoris. The second vein graft was then sewn end-to-side to the first vein graft in preparation for subcutaneous tunneling above the pubis to create a femorofemoral bypass.      

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Neoaortoiliac System (NAIS) Bypass of Infected Aortofemoral Graft: 18

A D V E R T I S E M E N T

   
 

The right common femoral artery was occluded, but the superficial femoral and profunda branches were patent beyond the bifurcation. The SFPV graft was sewn end-to-end to the patent superficial femoral artery. A separate segment of SFPV graft was used to bypass directly to the profunda femoris. The picture shows the anastomotic arrangements as seen from the patient's right side.      

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This page was last modified on 11/6/2000.